I remember the day I first met you. It was a quiet Sunday, early in the morning. I heard a commotion out by the check in desk, and your mom’s scream: “My baby’s not breathing!” The first time I saw you was in your mom’s arms. Heartbreakingly, you weren’t snuggled like a baby should be, or even limp. Your tiny body was twitching, seizing, curling up in the all too recognizable form of a massive head injury.
We rushed you to our trauma room, and the entire hospital came to help you. In moments, I had every hand available, every heart pulling for your tiny body. All of those hands let me do the hardest thing; step back and start making decisions that would alter your life forever.
Your tiny heart was so slow. I don’t know if you know this, but children’s hearts should be fast, like running feet and quick smiles. Yours was the slow stuttering pace of a heart about to surrender. I knew your heart was strong, but your brain was so hurt that your body was fading.
The next minutes were a blur of activity. I barked sharp, pointed orders, like the needles we used to drill into your bones. Monitors started to beep, not a single number reassuring. I was looking at you, every inch of you, measuring, assessing, cataloging all of the places that needed my gentle fingers.
My eyes kept wandering to your forehead. It was on your right side, just above your eyebrow. It was a big, violent, purple lump, and my gaze kept stumbling each time it passed over it. It was such an ugly wound on the surface, but no match for the devastation it hid underneath it.
My team worked so hard for you. I had so many smart people helping me with medications, IVs, monitors. Hands so big there wasn’t enough of your minute body for all of them to touch still reached for you, stroked gently and talked softly so you wouldn’t be scared.
I very clearly remember the moment I put you on the ventilator. I’ve done this procedure hundreds of times, but I noticed that my view was shaky. No, it was my hand. I had to stop, stare at those trembling fingers until they steadied. Two deep breaths for me, and your breathing tube was in.
After the ventilator began its metronome to mark the time, things quieted down. Your body started to respond to the seizure medicines, and your curling arms relaxed. Your heart rate, once so frighteningly lethargic, had responded to medication and ticked along. Your pupils in your beautiful blue eyes shrank back, now even once again.
The beat of the helicopter announced the arrival of your next phalanx of guardians. I had called for them the first minutes you were here, shouting information across the trauma room as my hands prodded your body, pleading for help to come. This small town hospital was not equipped for your tiny life and its huge injury, and I am forever grateful to those who answered my call and stood ready to help you.
The frenetic pace of doing slowed as you rolled out the door, mummified in pumps and vents and tubing. As you left my care, I looked over to those who loved you, who came to be with you during your fight. There was one man, the one who told me the first lies of your day, who would not meet my eyes. You fell and hit the corner of a wall, he said. He knew I knew better.
I wondered about you and worried about you. On the back of my eyelids, I can your forehead, the dividing line between that part of your life and this. I see your left hand, spasmed to your chest, then finally falling lax. I hoped for your miracle.
In the way of small towns, I heard bits of your story. I heard rumors of your surgery, saw pictures of you in daycare as a smiling happy child before that Sunday. I had a sad pride the day I heard you went home. I read the newspaper tale of the man’s evil who caused all of this, just because you wouldn’t hold still for a diaper change.
Then one morning, I was back in the same ER, sitting in the same chair as when I first heard your mom scream. The ambulance called, “2 year old male with TBI, trach/peg, coming with difficulty breathing.” My skin felt too tight; I knew it was you.
The lump on your head was gone, but it is replaced by a curlicue of scars. Your skin has taken on the slightly waxy appearance that seems so common to brain injured patients. I’m not sure if that’s something that happens because of your injury, or something from how we care for you. I’d recognize the sheen anywhere.
I talked to your mom again. She gave me a hug, and thanked me for saving her baby. Your grandma is amazing; she loves you so completely and perfectly, caring for you every day. We got to spend a little more time together, but you probably don’t remember either of our visits. I will never forget them.
I watched you lay on the bed, the occasional flicker of what I hope is a smile that means you find some joy. You love Moana, so your mom plays it over and over. I’m not sure if you know happiness, but you definitely know pain. As soon as my nurse began looking for an IV site, you fought as best you could, grimacing and trying to pull away. I hope that pain is not all you know.
I hope you forgive me. You were so close to gone, and I was so afraid you wouldn’t make it. Even then, I knew that making it would be relative, and the life I was saving you for would be troubled at best. I hope some part of you finds joy, and it overshadows the pain. I hope you remember a little, because I will never forget you.
I wonder: did I save you for a good life? Are you glad I did it? Will your mom and grandma still thank me, when the endless days of caring for you heap into years of sacrifice? Will you forgive me for saving you?